| NPI | 1356549265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053009) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: PA PT001921E) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-12-16 |